Cough Clinic

PulmoCrit Cough Clinic

Chronic cough — defined as a cough lasting more than 8 weeks in adults — is one of the most common reasons patients seek a pulmonary specialist. It's also one of the most commonly mismanaged: patients are often treated for one condition (like acid reflux or postnasal drip) without systematic investigation of the others. Our Cough Clinic uses a structured, cause-first approach — evaluating the most common triggers in sequence and adjusting the workup based on your specific history and test results.

Chronic cough can be caused by asthma or cough-variant asthma, upper airway cough syndrome (postnasal drip), gastroesophageal reflux (GERD), ACE inhibitor medications, non-asthmatic eosinophilic bronchitis, or — less commonly — lung cancer, pulmonary fibrosis, or other conditions. Many patients ultimately have more than one contributing cause. Getting to the right diagnosis requires a systematic approach rather than empiric treatment of one cause at a time. Request a cough evaluation →

Diagnosing chronic cough typically involves a thorough medical history, physical examination, and a series of diagnostic tests. The healthcare professional may ask questions about the onset, frequency, duration, and pattern of your cough, as well as any other symptoms you may be experiencing. They may also ask about your medical history, including any allergies, smoking history, exposure to environmental irritants, or recent illnesses.

Physical examination may involve listening to your lungs and heart with a stethoscope and checking for signs of respiratory distress or other underlying conditions.

Diagnostic tests may include:

• Chest X-ray or CT scan: to check for lung abnormalities or other potential causes of cough.
• Pulmonary function tests (PFTs): to evaluate lung function and rule out conditions like asthma or COPD.
• Sputum analysis: to examine the mucus you cough up for signs of infection or other abnormalities.
• Allergy testing: to identify any allergens that may be triggering your cough.
• Acid reflux tests: to evaluate for gastroesophageal reflux disease (GERD) which can cause chronic cough.
• Bronchoscopy: a procedure where a thin, flexible tube with a camera on the end is inserted through the nose or mouth to examine the airways for any abnormalities.

The treatment of chronic cough depends on the underlying cause. Once the cause has been identified through diagnostic tests, the healthcare professional can recommend appropriate treatment. Here are some common treatments for chronic cough:

• Medications: Depending on the underlying cause of chronic cough, your healthcare professional may prescribe medications such as antibiotics for bacterial infections, bronchodilators for asthma, or acid blockers for GERD.
• Lifestyle modifications: Making certain lifestyle changes can help alleviate chronic cough. These include avoiding environmental irritants like smoke, dust, or pollutants, staying hydrated, and avoiding allergens.
• Cough suppressants: In some cases, a healthcare professional may recommend cough suppressants to reduce the frequency or intensity of coughing.
• Pulmonary rehabilitation: For people with chronic lung conditions like COPD, pulmonary rehabilitation can be an effective treatment option. This may include exercise, breathing techniques, and lifestyle modifications.
• Surgery: In rare cases, surgical intervention may be necessary to treat the underlying cause of chronic cough, such as removing a tumor or repairing a structural abnormality in the airways.

It is important to work closely with your healthcare professional to determine the underlying cause of your chronic cough and to follow their recommended treatment plan.

The diagnostic tests will depend on the suspected cause of your chronic cough, and your healthcare professional will determine which tests are necessary for your specific situation.